All Publicity Is...What?

When I had finished my first reading and signing for Between Expectations, I was approached by a woman who had just bought the book. She wanted to tell me how excited she was to read it. Then she said something I found rather bizarre. She said, "You are so brave."

I have to confess I thought she must be somewhat addled, or at the very least misinformed. I am not brave. And I did not understand, at the time of our discussion, that I would need to be. I had not done anything particularly heroic, nor had I done anything particularly controversial.

Or so I thought.

In the introduction to the book I write about how I came to be granted time off from residency to write. Sixteen weeks off to be exact. Over the course of three years. Time for which I was not paid. Time that did not interfere with any of my fellow residents' call schedules. Time that I made up after all my friends had gone on to bigger and better things (there are rules after all). But time that was mine entirely. I did what I could with it. I wrote a book. I tried to tell the stories of some of the patients I had known in a way I thought would help others understand how hard it is for families to go through the significant illness of a child.

What is so horrible about that?

But apparently it is horrible. It is horrible on many counts. You see the thing that was compelling, the thing that interviewers honed in on and that everyone all of a sudden wanted to discuss, was that in that introduction I admitted that I sometimes struggled. In an effort to give context to the narrative that would come after, to offer insight at the same time as reassurance to those embarking on medicine as a profession, I confessed that I found the long hours and the stress of residency difficult.

Is there anyone out there who doesn't? Not only in medicine but other professions as well.

What I actually wrote about in the introduction is that good data exists that says this is not the safest way to practice medicine or train new doctors. The reason I "complained" was to be able to highlight some of the problems that exist with how residency training is practiced. The continued changes to residency scheduling are evidence that these problems are real and pressing. The discussion should and will continue, within the ACGME and within individual programs.

But that is not where the discussion has gone. Instead there is palaver about my personal faults. These do exist, I assure you, but they are mundane and trite and not overly remarkable. Why is it that to say that medicine is difficult, to say that there are days when you wonder if it would not be easier to have chosen something else, why does that mean you are unfit as a human being to be a doctor?

Of course I know the anonymity of the internet invites the cruelest parts of ourselves to surface and I'm finding that I accept this. I can take it. But what worries me is that for every thoughtless, hurtful comment made about me and sometimes about doctors in general, there is a bright and gifted college student out there who is considering applying to medical school and ultimately decides not to. I have gotten emails from more than a few, asking for words of wisdom, begging to be told that in the end it all is worth it.

The young, idealistic eighteen year old does not and should not want to embark on a career in which it seems acceptable to accuse a colleague of being weak or stupid or lazy simply because she dared to introduce the question: How do we strive to find balance in our lives in a field that demands continued learning and constant improvement? These are not questions for medicine alone to answer. They are ones we should each struggle with throughout our lives, lest we lose the parts of ourselves that we hold most dear.

Financially speaking, medicine as a career is not worth it. You can find the numbers here. Emotionally speaking, well I hope it is. I hope that in the end the wonderful moments I experience with patients and their families outweigh the tedium of the paperwork and the dictations. I hope that my jobs fits itself around my family, not the other way around, because as much as medicine is a calling, being a mother is the most important job I can imagine. And I hope, as I continue to call for help when I need it, unapologetically, my work colleagues know how much I appreciate their input, as I know that they do mine.

The other negative responses to some press, borne out of frustration with a medical system that cannot always cure what ails you, I have no quick fix for. But might I suggest, if you need something that your doctor is not providing, a better explanation of a decision or even just emotional support, tell them. To their faces. You might be surprised at how eager they are to please. After all, helping people is what this business is all about.